Fluoridation is the act of adjusting fluoride levels in water, with the goal of reducing tooth decay. In 1945, Grand Rapids, Michigan was the first city in the world to do it. In 1999, the CDC declared that water fluoridation was one of the ten great public health achievements of the 20th century. However, a quick online search will yield countless articles discounting these claims, with the general consensus of the dissenters being that fluoride is actually harmful to one’s health. So which is it? Is fluoride good or bad for you?
To answer that, let’s take a closer look at fluoride, what it does in the body, and why governments of the world think it’s so beneficial.
In the early part of twentieth century, Dr. Frederick McKay noticed that his patients in Colorado Springs had brown stains on their teeth. He, along with Dr. G.V. Black, termed the condition as mottled enamel. Now known as enamel fluorosis, they also found those brown stains appeared to give people a surprising resistance to tooth decay. They hypothesized that something about the drinking water was the cause. In the 1930s, it was shown that fluoride was the culprit giving the stains and the protection against cavities.
Fluoride, in general, is a very common natural compound. Its base element is fluorine, the most electronegative of all elements. (In a nutshell, electronegative means it wants electrons like a a cat wants catnip.) It’s found pretty much everywhere in nature, including the food you eat, and, contrary to what many people think, even in the untreated water you drink. Fluoride naturally attracts calcium, so in the body it’s mainly associated with calcified tissues, like bones and teeth.
Fluoride will combine with hydrogen to form the acid hydrogen fluoride. Most of the reactions, like it’s absorption through the stomach, and the way kidneys clear it from your system, is due to how hydrogen fluoride reacts as it’s distributed throughout the body.
For a healthy adult, about 50% of fluoride consumed is retained by calcified tissues; the other half is excreted in urine. In children, as much as 80% is taken in by calcified tissues. This is because kid’s bodies are still growing relatively rapidly. Thus, fluoride will attract and help calcify those developing teeth and bones. The older you get, the less your body needs per unit mass, so more fluoride is excreted and less is retained.
So what is the recommended intake of fluoride? That depends on your age. Since almost all nutrients needed are based on an amount proportional to your mass (in this case measured in weight), the older you get, the more per day you need. For example, infants 0-6 months need about .01 mg/day. At 4-8 year of age you need about 1mg/day, and at 9-13 need about 2mg/day. Over the age of 19 and the amount is around 4mg/day for men and 3mg/day for women.
As previously mentioned, fluoride is found almost everywhere, including your food. For example, when you consume 100 grams of table wine, you’ll also be naturally consuming about 0.2 mg of fluoride; with 100 grams of seedless raisins about 0.23 mg, the same amount of brewed tea gives you 0.37 mg, and cooked crustaceans, like crab and shrimp, 0.16 mg.
The question then becomes, if fluoride is found in so many things, and we take it in daily, why did they start adding it to water? The answer is that studies showed that in areas where water isn’t fluorinated, the average dietary intake for adults was 0.3-1 mg per day- far less then the recommended intake for optimal health for adults. For areas where fluoride in the water was 1mg/liter, the average intake was 1.4-3.4 mg per day. Just about the right amount an adult body needs to fight off those expensive cavities, among other benefits.
So how does fluoride help with tooth decay?
Cavities, known as dental caries, begin when bacteria start propagating in the small cracks and crevices of your teeth. The plaque that naturally builds up contains copious amounts of these microbes, such as streptococcus mutans and Lactobacillus. When the bacteria begin to consume carbohydrates, mostly the high concentrations of sugar found within the foods and drinks we consume, they produce acids. When those acids create a pH less than 5.5, they will begin to dissolve your tooth enamel (carbonated hydroxyapatite). The entire process is called demineralization.
Should you get rid of the sugars, and are the one and only person to follow your dentist’s advice to brush and floss after every meal, ions from your saliva will help with rebuilding tooth enamel (remineralization). When demineralization exceeds remineralization, a cavity forms. That process usually takes months to years.
When fluoride is placed on your teeth, it combines in plaque fluid, along with the dissolved hydroxyapatite found in your tooth veneer, and will create a layer on your teeth called fluoridated hydroxyapatite (FHA).
FHA limits the uptake of…
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